Practitioners’ characteristics, practice location and practice type
Among the 185 practitioners who completed the questionnaire, 34 represented the Western region, 29 represented the Midwest region, 30 represented the Southwest region, 30 represented the South Central region and 31 practitioners each represented the South Atlantic and Northeast regions of the National Dental PBRN. Table 1 summarizes practitioners’ characteristics, practice location and type. One hundred nineteen practitioners were male (64%) and 66 (36%) were female. The majority (79%) identified themselves as White, 4% as African-American, 10% as Asian and 7% as other racial category. Practitioners’ ages differed significantly by network region (p = 0.02). Practitioners in the Northeast and the South Central regions were the oldest (mean (SD) age of 56.1 (11.15) years) and practitioners from the South Atlantic region were the youngest (mean (SD) age of 48.7 (12.17) years; p = 0.02, ANOVA).
Diagnosis of Dentin Hypersensitivity
Table 2 summarizes the most frequent methods practitioners reported using when diagnosing DH. Spontaneous patient report confirmed by the dental examination, was chosen most frequently as the first choice (48%). This was followed by applying air blast (26%), scratching dentin with a dental explorer (12%), patient report after dentist’s query (6%), using other methods, most likely applying endo-ice (4%), and applying cold water (2%).
As shown in Table 3, the practitioners reported using multiple products when managing DH. Almost all practitioners (97%) reported routine use of fluoride formulations, followed by desensitizing over-the-counter (OTC) potassium nitrate toothpaste (94%). Glutaraldehyde/HEMA products were reported as being used routinely by 42% participating in the survey. Interestingly, bonding agents and restorative treatments were reported to be used routinely respectively by 52 and 64% of the practitioners when treating DH.
As shown in Table 4, practitioners reported that the most frequent, practitioner reported, first choice of products used when managing DH was: OTC potassium nitrate toothpaste (48%), followed by fluoride formulations (38%) and glutaraldehyde/HEMA products (3%). Four percent of the practitioners reported giving advice (i.e., related to diet and dental habits) to their patients as their first choice of treatment modality. A total of 86% of the respondents reported using a combination of products when treating DH, most frequently fluoride varnish and desensitizing OTC potassium nitrate toothpaste (70%).
As summarized in Table 5, practitioners indicated their first choice of potential factors that may be related to dentin hypersensitivity. Recessed gingiva was chosen by 66% of the practitioners, followed by abrasion, erosion, abfraction and/or attrition lesions (59%). Thirty two percent indicated that bruxism contributes to DH and that it was their first choice of predisposing factors. Excessive tooth whitening and frequent consumption of citric juices and/or carbonated drinks were chosen by 17 and 15% of practitioners, respectively, as first choices for predisposing factors of DH.
Diagnosis, management and predisposing factors, by network region and practitioners’ characteristics
Practitioners’ diagnostic and management methods did not differ significantly across the six network regions. There were no age differences in diagnostic methods, except for using “other methods” to diagnose DH (p < 0.0001, Fisher’s exact test). Only 2% of practitioners in the younger age category (younger than 55 years) indicated using “other methods”, compared to 20% in the older age category (55 years of age and older). Most of the responses in the “other” category suggested using soft bristle toothbrushes, recommending gingival grafting, occlusal adjustments, and fabricating occlusal guards.
There were no practitioner gender differences in diagnostic methods, except when using an explorer (p = 0.015, Fisher’s exact test). More male dentists than female dentists use a dental explorer to diagnose DH (84 versus 68%).
There were no regional differences in dentists’ beliefs regarding predisposing factors to DH, except for bruxism (p = 0.047, chi-square test). The highest percentage of practitioners from the South Atlantic region (87%) had chosen bruxism as one of the predisposing factors of DH; the lowest percentage was chosen by practitioners from the Western region (53%).
The practice locations did not differ significantly across the 6 regions, however the practice type did differ significantly by region (p < 0.0001, chi-square test). Almost 87% of practitioners from the Southwest and the South Central regions identified themselves as owners of a private practice, 83% practitioners from the South Atlantic region, 74% practitioners from the Northeast region, 59% practitioners from the Western region and 52% of practitioners from the Midwest region.